Syndromes of the head and neck of dental origin. I. Pain caused by mandibular dysfunction.

History The diseases and disturbances which are attributed to disorders of the temporomandibular articulation present one of the most controversial problems in medical and dental science. Freese1states that as early as 3000 B.C. the anatomy of this joint and "dislocation of the mandible" were known. He very aptly brings the history of the subject up to date, and so no further remarks will be necessary at this time. The Problem The subject of temporomandibular joint disturbance and resultant pain or other sequelae was brought to the attention of the medical and dental professions by Costen, in 1934.2Dentists had noted these phenomena even before Costen described thesyndrometo which his name has been given. Costen3-5described his symptom-complex as occurring uniformly in disturbed temporomandibular joint function. The symptoms were described as follows: (1)ear symptoms, such as loss of hearing, stuffy sensation in the ears,